Pediatric Therapy Source

LBN: Pediatric Therapy Source
Pediatric Therapy Source is an health care organization with primary practice located at 18809 Mariner Inlet Dr , Boca Raton FL 33498-6367. The organization recently has 3 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Agencies / Early Intervention Provider Agency, Ambulatory Health Care Facilities / Clinic/Center. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is the primary health care specialty. Pediatric Therapy Source can be contacted via phone (732) 232-1126, or through Berg, Alison via phone (732) 232-1126.

Contact Information

Primary practice address
18809 Mariner Inlet Dr Boca Raton FL 33498-6367
Phone: (732) 232-1126
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berg, Alison MS CCC SLP
Phone: (732) 232-1126

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X
Agencies / Early Intervention Provider Agency 252Y00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1528726619
LBN Legal business name Pediatric Therapy Source
DBA Doing business as
Authorized official Berg, Alison MS CCC SLP
Entity Organization
Organization subpart 1 No
Enumeration date Dec 6th, 2021
Last updated Dec 22nd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528726619 NPPES
Florida MEDICAID 016604900

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